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MGH Community News |
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MGH Community News |
| June 2024 | Volume 28 • Issue 6 |
Highlights
Sections Social Service staff may direct resource questions to the Community Resource Center, Hannah Perry, 617-726-8182. Questions, comments about the newsletter? Contact Ellen Forman, 617-726-5807. |
Emergency Shelter Time Limits – First 90-Day Time-Limit Notices Scheduled for July 1 The Massachusetts legislature passed a law in April that sets a nine-month limit on families’ time in the EA Emergency Family Shelter program. Families will be given 90-days notice to allow them time to transition out of the shelters. Families who have been in state shelter for longer than nine months could begin receiving notices on July 1 that they have 90 days to leave and find other housing accommodations, with the first families scheduled to be kicked out of the system as early as Sept. 29. About 4,000 of the 7,500 families in the system have been living in shelters for more than nine months, according to the Executive Office of Housing and Livable Communities (EOHLC). The guidance outlines a rolling start for these notices – so not every family whose stay is longer than nine months will be affected immediately. A new law agreed to this year by the Legislature and Gov. Maura Healey put a limit on how long families can stay in shelter, and it also said no more than 150 families should be removed by the state every week, not counting families who leave on their own. According to the implementation plans, the executive office will give 90-day notices to no more than 150 families for the full month of July, though they may increase the pace of removals in subsequent months. Every family that has been in shelter for longer than nine months will receive one of three notices in July: informing them they need to leave soon but are eligible for a 90-day extension and providing them with a termination date; letting them know they are not eligible for that 90-day extension and giving the date by which they will have to leave; or informing a family that they have not been selected to leave this month, but may be selected soon. Of the 4,000 families who are over the nine-month limit, EOHLC will choose which 150 to send the first removal notices to based on which families they believe are the best positioned to succeed out of the shelters, officials said Wednesday. They will also make location-based decisions aiming to not overwhelm certain regions of the state by removing dozens of families from shelter in the same area at once, officials said. The guidance also spells out eligibility criteria for the two 90-day extensions that families may apply for, as well as the details of “hardship waivers.” The guidance says that a family who has exhausted both 90-day extensions may apply for an additional “hardship waiver” extension of up to 120 days in particular circumstances. To qualify for this hardship waiver, a family must be in compliance with a rehousing assessment and meet certain criteria, including having: a baby aged 0 to 3 months, a family member with an immunocompromised condition, a high-risk pregnancy, a family member with a medical device (trache), or risk of imminent harm due to child protection or domestic violence concerns.
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The guidance also outlines an appeal process, and makes clear that families who leave an emergency shelter unit on or before their termination day can re-apply for shelter immediately, though they would be subject to the same waitlist and prioritization process as every other new applicant. As of mid June the waitlist had around 800 families hoping to get a spot in shelter. By starting the 90-day clock this summer, EOHLC is applying the law legislators and Healey approved this spring retroactively to the start of 2024, instead of beginning to count nine months from when the law was passed or notices are sent out. Providers have objected to this interpretation, saying it doesn’t give families and providers enough time to find other accommodations for homeless families. Extension Eligibility To qualify for a 90-day extension, a family must be in compliance with their 60-day Rehousing Assessment and meet one of the following criteria:
Hardship Waiver Eligibility Once a family has exhausted their two 90 day extensions, they may qualify for a Hardship Waiver. To qualify for a hardship waiver, a family must be in compliance with their 60-day Rehousing Assessment and meet the criteria to be Priority 1 using the Clinical Safety Risk Assessment outlined in EOHLC’s Guidance on Waitlist and Prioritization Procedures:
Requests for a hardship waiver must be submitted on a form or medium provided by EOHLC at least 30 days prior to the family’s LOS Limit As part of the waiver request process, families will be required to undergo a clinical evaluation to assess whether they qualify as Priority 1. Families may choose how they have their assessment completed:
Appeals Families will have the right to appeal: The date of their LOS Limit based on a denial of an extension or denial of a hardship waiver. Appeal requests must be received by the EOHLC Hearings Division within 21 days of the issuance of the notice that is being appealed. Families will be able to remain in shelter while their appeal is pending if the appeal request is timely received. If the appeal is denied by the EOHLC Hearings Division, the family will have 10 calendar days to leave shelter from the date of the issuance of the hearing officer’s decision. Re-application for EA Shelter Families who leave their EA shelter unit on or before the last day of their LOS Limit (as extended) may re-apply for shelter immediately, subject to waitlist and prioritization process, and will not be subject to the 12-month bar on EA eligibility For more information see the full program guidance (released 6/12/24). - See the full Commonwealth Beacon article. Additional material from the program guidance.
Biden Gives Legal Protections to Undocumented Spouses of U.S. Citizens President Biden this month granted far-reaching new protections for hundreds of thousands of immigrants who have been living in the United States illegally for years but are married to American citizens. To be eligible, the spouses must have lived in the United States for 10 years and been married to an American citizen as of June 17. They cannot have a criminal record. The benefits would also extend to the roughly 50,000 children of undocumented spouses who became stepchildren to American citizens. Eligible non-citizen spouses and their children will be eligible for Parole-in-Place for a three-year period in which they can apply for adjustment of status to lawful permanent residents if they meet all the requirements for adjustment. Parole-in-Place allows eligible spouses and step-children to adjust to green card status while staying in the United States. The new benefits for undocumented spouses will not take effect right away; senior Biden administration officials said they expected the program to begin by the end of the summer. Those eligible will then be able to apply for the benefits. There is no application available at this time. Mr. Biden is relying on a program known as “parole in place,” which has been used for other populations like families of military members. The status gives noncitizens the ability to temporarily live and work in the United States without fear of deportation. Under the new policy, some 500,000 undocumented spouses will be shielded from deportation and given a pathway to citizenship and the ability to work legally in the United States. It is one of the most expansive actions to protect immigrants since Deferred Action for Childhood Arrivals, or DACA, was enacted 12 years ago to protect those who came to the United States as children. “These couples have been raising families, sending their kids to church and school, paying taxes, contributing to our country,” Mr. Biden said at the White House, where he was joined by members of Congress and DACA recipients, known as Dreamers. “They’re living in the United States all this time with fear and uncertainty. We can fix that.” Mr. Biden also said he would make it easier for young immigrants, including Dreamers, to gain access to work visas, a significant move that could help them eventually get a green card. That would protect their legal status even if DACA, which is already tied up in litigation, disappears. “We’re a much better and stronger nation because of Dreamers,” Mr. Biden said, as he marked the anniversary of the Obama-era DACA program. The new policy allows Mr. Biden to balance his recent crackdown on asylum with a sweeping pro-immigrant measure at a moment of political peril. With five months until the presidential election, Mr. Biden has been trying to curtail record numbers of illegal border crossings without alienating longtime supporters who have called for a more humane immigration system after the Trump years. The policy aims to help people who have been living in the United States for more than a decade, building lives and families here. Even though marrying an American citizen generally provides a pathway to U.S. citizenship, people who crossed the southern border illegally — rather than arriving in the country with a visa — are required to return to their home countries to complete the process for a green card. The new program allows them to remain in the country while they pursue legal status. In the years since President Barack Obama created DACA in 2012, it has allowed hundreds of thousands of young adults to get jobs and live without fear of deportation. But DACA has been closed to new applicants since 2017, when Mr. Trump tried to end the program. It remains ensnared in litigation, and its long-term survival remains in question, even though it was revived for existing beneficiaries. Participants are now, on average, in their mid-30s. Recipients who were once children fearful of having their parents deported “are now the parents afraid of getting deported,” said Bruna Bouhid-Sollod, a senior political director at United We Dream Action, an advocacy group for DACA recipients. Mr. Biden appeared intent on addressing those fears with this announcement that the administration would make it easier for Dreamers to be sponsored for a work visa by their employer. See (and share!) the Affirmative Relief Announcement Flyer. - See the full The New York Times article with additional material from Statement on New Immigration Actions, new-arrivals-working-group@miracoalition.org on behalf of Heather Yountz, June 20, 2024 (thanks to Fiona Danaher for sharing.)
Permanent MA Summer EBT Food Program for Children Announced The Healey-Driscoll administration has announced that Massachusetts has received federal approval for its new summer child nutrition program. Following the ending of Summer Pandemic EBT (P-EBT), this new child nutrition program, known simply as Summer EBT,will help feed an estimated 600,000 students while schools are closed for the summer. Low-income Massachusetts families with school-aged children will be eligible to receive financial assistance to buy groceries, bringing more than $70 million in federal funds to the state’s economy. Summer EBT will be administered by the Department of Transitional Assistance (DTA) in collaboration with the Department of Elementary and Secondary Education (DESE) and local school districts. This new program will complement the Summer Eats program, which provides free meals to all kids and teens, ages 18 and under, at locations across Massachusetts during the summer months. Some students’ families will also continue receiving regular SNAP (federal Supplemental Nutrition Assistance Program) benefits. Eligible families will receive one payment of $120 per child between July and September, corresponding to $40 per month. Families already enrolled in SNAP, Temporary Assistance for Needy Families (TANF; known in Massachusetts as Transitional Aid to Families with Dependent Children, or TAFDC), or some MassHealth plans will be automatically enrolled in the summer child nutrition program and do not need to take any action. Families who are not automatically enrolled can apply for the program directly on DTA Connect between June 15 and September 7, 2024. “In Massachusetts, we are not leaving federal dollars on the table that could support children and families’ food security. In partnership with our State Legislature, we made universal free school meals permanent. And with this new program, we are working to ensure children and families have access to healthy food all year long,” said Governor Maura Healey. “I want to thank the Biden-Harris Administration and Congress for permanently establishing this child nutrition program. Massachusetts is proud to be utilizing all tools available so kids can focus on learning and play, not where their next meal is coming from.” “This child nutrition program is a big win because it makes sure children have access to healthy meals through the summer months, when we know families’ food costs increase. It also supports our local businesses, grocery stores, corner stores, and farmers,” said Lieutenant Governor Kim Driscoll. FAQs Who is eligible for Summer EBT? Students qualify for Summer EBT if during the 2023-2024 school year they:
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Note: this program is available regardless of immigration status. Do I need to apply for Summer EBT? Most eligible families in Massachusetts do not need to apply to get Summer EBT. DTA will issue Summer EBT benefits automatically to most eligible families. For example, if during the 2023-2024 school year your child/children got SNAP, DTA cash benefits, certain types of MassHealth coverage, SSI, or were in foster care, you do not need to apply. How do I apply for Summer EBT? Students who are not automatically enrolled (see above) in Summer EBT can apply online on DTA Connect starting June 15 or right now through a paper application with their school. Check back soon for more information about the paper application. Students are eligible if they attend a NSLP/SBP school and if their household meets NSLP/SBP income limits. What time period does Summer EBT cover? Summer EBT is a benefit for the summer months. In Massachusetts, the summertime period is from June 13, 2024, to September 7, 2024. Students can apply for Summer EBT until September 7, 2024. How much money will my student get for Summer EBT? Summer EBT provides $40 a month to qualified students for the three summer months. DTA will issue a one-time payment of $120 to eligible students. How will I receive the Summer EBT benefit? If you or someone in your household already receives SNAP or DTA cash benefits, DTA will put Summer EBT benefits on your existing EBT card. If no one in your home receives DTA benefits, the benefits will be paid on a new Summer EBT card in the name of the parent/guardian who is completing the application. For eligible families on MassHealth, the new Summer EBT card will be in the name of the head of the household. If the student is in foster care, the new Summer EBT card will be in their name. DTA will begin mailing out Summer EBT cards in July if you do not currently have an EBT card. Check back for more information. Sources and for More information
CHAMP Application Now Includes MRVP In the past, you could apply for MA state-funded public housing and the Alternative Housing Voucher Program through the CHAMP (State-Funded Public Housing) online application system, but not the Massachusetts Rental Voucher Program (MRVP). That has changed - MRVP applications can now be submitted through CHAMP. Any active Public Housing, MRVP, or AHVP applications previously submitted on paper to a housing agency are now online in CHAMP. You may search for your application and create an account online using the CHAMP website. Click here for instructions for new and returning applicants. To use the paper application instead, click here and mail it or go to any housing agency. - From HousingWorks: New Applications/Waitlists, HousingWorks.net, June 17, 2024 with additional material from https://publichousingapplication.ocd.state.ma.us/help/
How Public Pensions Reduce Social Security Benefits in Retirement For those who work for municipal or state governments and expect to draw a public pension someday, it’s important to know about the Government Pension Offset, as well as something called the Windfall Elimination Provision, which also may reduce Social Security benefits for those who begin taking a public pension. Here’s what you should know: What is the Government Pension Offset? It’s a law passed 40 years ago that primarily affects state and local government employees, like teachers, police officers, and firefighters. Those workers receive a pension based on earnings that are exempt from Social Security payroll taxes. By contrast, private-sector workers pay 6.2 percent of wages in Social Security taxes, an amount that is matched by their employers. Congress in 1983 enacted the GPO to address the apparent preferential treatment of those public-sector workers who do not pay into the Social Security system. What was the rationale for the GPO? It’s complicated, but, in essence, Congress concluded that people who receive both a public pension and some form of Social Security benefits (as a spouse, widow, or widower) were treated more generously than those who worked only in the private sector. It was intended to eliminate an unintended but apparent inequity. Debate goes on in Congress to this day on whether the GPO goes too far (or not far enough) and should be adjusted. How does it work? If you are receiving a Social Security survivors benefit and you begin taking a public pension, the Social Security Administration will reduce your Social Security benefits by an amount equal to two-thirds of the amount you receive in your new public pension. Does the GPO affect only survivors, that is, widows and widowers, receiving Social Security benefits? No, there is another category of people who may be affected by the GPO — those married people who may be eligible to collect up to 50 percent of their spouse’s Social Security benefits. What is the Windfall Elimination Provision? The WEP comes into play when you begin taking a public pension while receiving your own “earned” Social Security benefits. To qualify for basic Social Security retirement benefits, you need to have worked in the private sector (while paying Social Security taxes) for a minimum of 10 years, though it doesn’t have to be consecutive years (you need 40 “quarters,” that is, 40 three-month periods). If you qualify and begin taking your earned Social Security benefits, those benefits will be reduced when you begin taking your pension. What was the rationale for the WEP? The formulas are complicated, but suffice it to say the system strives to provide a safety net, particularly for long-term, low-wage earners. The way it does that is by counting 90 percent of your first $1,174 a month in earnings toward your benefits. As income increases, the percentage used to calculate your benefits decreases on a sliding scale. One unintended consequence of this sliding-scale calculation is that it gives an economic advantage — a “windfall” — to those retirees who worked in the private sector long enough to qualify for benefits before going to work in the public sector and earning a pension there. The WEP was intended to eliminate that advantage. Like the GPO, it remains controversial and subject to continuing political debate. How much does the WEP reduce my Social Security benefits when I begin taking a public pension? The WEP cuts your Social Security benefits by a percentage based on how many years you had substantial earnings in the private sector; the more years you had (and thus the more you paid into the system), the higher percentage of your Social Security benefits you are allowed to keep. The Social Security Administration provides an online WEP calculator. - See the full Boston Globe article.
Biden Administration Announces a Plan for Removing Medical Debt From Credit Reports Americans would no longer have to worry about medical debts dragging down their credit scores under federal regulations proposed Tuesday by the Consumer Financial Protection Bureau. If enacted, the rules would dramatically expand protections for tens of millions of Americans burdened by medical bills they can’t afford. Administration officials said they plan to review public comments about their proposal through the rest of this year and hope to issue a final rule early next year. The regulations would also fulfill a pledge by the Biden administration to address the scourge of health care debt, a uniquely American problem that touches an estimated 100 million people, forcing many to make sacrifices such as limiting food, clothing, and other essentials. “No one should be denied access to economic opportunity simply because they experienced a medical emergency,” Vice President Kamala Harris said. The administration further called on states to expand efforts to restrict debt collection by hospitals and to make hospitals provide more charity care to low-income patients, a step that could prevent more Americans from ending up with medical debt. And Harris urged state and local governments to continue to buy up medical debt and retire it, a strategy that has become increasingly popular nationwide. Credit reporting, a threat traditionally used by medical providers and debt collectors to induce patients to pay their bills, is the most common collection tactic used by hospitals, a KFF Health News analysis has shown. Although a single unpaid bill on a credit report may not hugely affect some people, the impact can be devastating for those with large health care debts. There is growing evidence, for example, that credit scores depressed by medical debt can threaten people’s access to housing and fuel homelessness. People with low credit scores can also have problems getting a loan or can be forced to borrow at higher interest rates. “We've heard stories of individuals who couldn't get jobs because their medical debt was impacting their credit score and they had low credit,” said Mona Shah, a senior director at Community Catalyst, a nonprofit that’s pushed for expanded medical debt protections for patients. CFPB researchers have found that medical debt — unlike other kinds of debt — does not accurately predict a consumer’s creditworthiness, calling into question how useful it is on a credit report. The three largest credit agencies — Equifax, Experian, and TransUnion — said they would stop including some medical debt on credit reports as of last year. The excluded debts included paid-off bills and those less than $500. Those moves have substantially reduced the number of people with medical debt on their credit reports, government data shows. But the agencies’ voluntary actions left out many patients with bigger medical bills on their credit reports. A recent CFPB report found that 15 million people still have such bills on their credit reports, despite the voluntary changes The proposed rules would not only bar future medical bills from appearing on credit reports; they would also remove current medical debts, according to administration officials. Officials said the banned debt would include not only medical bills but also dental bills, a major source of Americans’ health care debt. Even though the debts would not appear on credit scores, patients will still owe them. That means that hospitals, physicians, and other providers could still use other collection tactics to try to get patients to pay, including using the courts. Patients who used credit cards to pay medical bills — including medical credit cards such as CareCredit — will also continue to see those debts on their credit scores as they would not be covered by the proposed regulation. Many groups are also urging the federal government to bar tax-exempt hospitals from selling patient debt to debt-buying companies or denying medical care to people with past-due bills, practices that remain widespread across the U.S., KFF Health News found. - See the full NPR story.
Addressing Gaming, Gambling, and internet Addiction in Young Adults “Video games, apps and websites are often designed with input from behavioral psychologists to make them as engaging as possible,” says Kyle Faust, PhD, MGH psychologist. “In some cases, games or digital technology are incentivized to keep users spending as much time as possible using these technologies because it allows them to run more advertisements to make more money. It’s become a growing problem; about 8 to 10% of Americans struggle with gaming disorder, gambling disorder and or problematic digital technology use. These numbers are likely to continue rising as virtual and augmented reality make these technologies more enticing.” The Mass General Addiction Recovery Management Service (ARMS) of the MGH Psychiatry Department, is working to address this by expanding its current programs to include a novel treatment track for teenagers and young adults. ARMS tapped Faust to create and lead this new program, relying on his expertise in the overuse of digital technology to achieve positive clinical results. In this new treatment service within ARMS, patients will report about their overall screen use and if it negatively impacts their social, occupational or academic life. Symptoms such as preoccupation with these technologies, excessive time spent, withdrawal symptoms or an inability to successfully reduce screen time despite the negative consequences are typically assessed. If patients meet a certain number of these and other symptoms, they might require clinical support and intervention. “We see people sometimes having trouble at school because they game all night and don’t get enough sleep,” says McKowen. “They may be stealing their parent’s credit card and racking up charges in online games, buying tokens to level up their play. Or, they may pass on hanging out with friends to stay home and play videogames. These are all scenarios we can address.” The clinic will begin accepting patients in July. Treatment will include cognitive behavior therapy utilizing an evidence-based approach tailored to individuals struggling with these disorders. Care will be offered remotely to patients throughout Massachusetts, while some in-person appointments will be available at the Wang 8 location. For more information, email MGH-arms@partners.org. - Source: https://www.massgeneral.org/news/article/gaming-gambling-and-internet-addiction-in-young-adults
Benefits Check-Up Creates a Personalized Potential Benefits List The cost of aging in America is on the rise. Social Security provides retirees with a stable income. Unfortunately, it’s not always enough to cover the costs of health care, food, housing, and utilities. When the cost of living rises faster than your income, it can be difficult to make ends meet in retirement. The good news is there are public and private benefits programs that can help older adults afford daily expenses. The bad news is that millions of eligible people are missing out on this help. These are a few of the biggest missed benefits:
There is a safe and trusted way to find out if you may be eligible for these or other benefits programs. It’s called BenefitsCheckUp®. NCOA offers this free, easy-to-use tool that features more than 2,000 public and private benefits programs available in all 50 states and the District of Columbia. Visitors enter confidential information while remaining anonymous. They instantly get a report of programs they may be eligible for—plus next steps on how to apply. - See the full SSA Blog post.
The Family Self Sufficiency Program the Best Kept Secret to Homeownership or Other Financial Goals Homeownership is a dream for many Americans, and Jenny Marcelin was no exception. In the fall of 2020, she got a flyer in the mail advertising something she thought was too good to be true — an obscure federal program that would allow her to leverage her rent to save toward a nest egg. The 34-year-old program, called the Family Self Sufficiency program or FSS, allows participants who live in public housing to save some of the money they would typically pay toward rent to reach certain financial goals, such as buying a new car, paying off college debt, or starting a business. For Marcelin, that meant saving around $8,600 that helped with a down payment on her first home, in Hyde Park. In the affordable housing world, some experts ironically refer to FSS as one of the best-kept secrets: It’s a resource that could help more people buy a home or pay off debt, and yet so few people know it exists. Indeed, Massachusetts housing authorities served about 4,500 FSS participants last year, but 87,000 more people could benefit from the program. The program is unique because it leverages what’s known as the benefits cliff, a phenomenon where even the smallest wage increase can push a low-income household above a maximum income limit for the public benefit they depend on. For a homeowner, that would be akin to a mortgage payment increasing every time they received a raise or promotion. So rather than celebrating the accomplishment, people living in affordable housing may dread the change as they risk losing out on the very resource they need to stabilize. That’s where FSS kicks in, offering families the ability to save what they would have paid as their rent increased in a separate escrow account. Participants typically stay in the program for five years and can save between $6,000 to $8,000. Nearly three-quarters of the heads of household who participate in FSS are Black or Hispanic and Latino, according to a 2019 report. “This type of program is the pathway out of poverty,” Omolade said. “Without a program like this, oftentimes it’s absolutely impossible to save because you’re literally living paycheck to paycheck.” The program also comes with financial coaches, who can provide expertise and accountability for recipients, supporting them through their goals with quarterly check-ins. They also provide budgeting and savings workshops along Word of mouth has so far been their most successful way of reaching new members, but it has not proven to be enough. Another barrier to scaling the program is that housing authorities have to choose to offer the program. Across the state, only 42 housing authorities — or roughly 17 percent — do so, according to the state Office of Housing and Livable Communities. Most providers in Massachusetts don’t because staffing and resources are limited; they are not equipped to manage escrow accounts for residents or handle the additional paperwork that comes with participating in a federal program. There has been a push to change the FSS program so that recipients of affordable housing are automatically enrolled and have to choose to opt out. That would make it easier for residents to start saving and reap the benefits of the program. - See the full Boston Globe article.
MassHealth Doula Program is Up and Running - Brochure Available in Seven Languages MassHealth announced last fall that it will cover Doula services for up to eight hours of perinatal visits per perinatal period without prior authorization. Visits above these limits will require prior authorization. MassHealth’s new Doula Services Program flyer is now available in seven languages. The flyer covers what a doula is, the kinds of support doulas offer, and how MassHealth members can connect with a MassHealth doula provider. The flyer also includes a doula webpage for MassHealth members. Background Those who experienced uncomplicated pregnancy, childbirth, and postpartum course would generally qualify only for the standard up to 8 hours of services. Criteria to request additional hours, above the 8 standard hours, via prior authorization include (not an exhaustive list):
MassHealth’s new Doula Services Program flyer is now available in seven languages: English, Spanish, Portuguese, Haitian Creole, Chinese, Cape Verdean Creole, and Vietnamese. The flyer covers what a doula is, the kinds of support doulas offer, and how MassHealth members can connect with a MassHealth doula provider. The flyer also includes a doula webpage for MassHealth members. - From Online Tracking Case, Cyber Rules Coming, and more, MHA's WEEKLY WRAP-UP, June 21, 2024.
Cultural Differences and Limited Resources Can Cost Migrant Families Their Children Buses carried the mother and son for much of their journey to the United States from Chile, but when they reached Panama, there were no vehicles to bring them through the isthmus’s jungles. For three days, they walked. When the 4-year-old tired, his pregnant mother carried him, driven forward by the promise of a life with more opportunities. Surrounded at times by a thousand strangers, the pair never separated. That changed on Feb. 1, after the family arrived in Massachusetts, when the Department of Children and Families took custody of the 4-year-old and the infant, who was born in December. The trigger was the mother’s hospitalization for postpartum depression, but her lawyer called that a misdiagnosis stemming from her poor knowledge of English and misunderstanding of health care workers’ questions. Because her husband was staying at a men’s shelter at the time, she had no one else to care for them. Although she was only hospitalized for six days, the family remains separated four months later. “When I talk about it I feel very sad,” said the mother, who is from Haiti. Lawyers, social workers, and health care providers worry about the trauma inflicted on already traumatized migrant families involved with Massachusetts’ child protection system. While intervention is sometimes warranted, they say, migrant families can find themselves involved with DCF because of a lack of resources, or due to ignorance of American parenting standards. Language barriers and cultural misunderstandings also led to referrals to DCF or family separations, said providers, including a DCF social worker who spoke on condition of anonymity. “Recent migrants, they’re trying to lay a foundation for their family in terms of meeting the basic needs of school and health care and housing,” said Jacob Chin, a lawyer with the Harvard Legal Aid Bureau, which represents parents investigated by DCF. “The added layer of DCF is just unnecessary for most of these families.” While national experts acknowledged migrant families’ situations can be complicated, and options limited, cases such as the Haitian mother’s highlighted how resources, such as easier access to care or treatment options that don’t require a parent’s isolation from their child, are lacking. Without them, unexpected emergencies for parents can quickly turn catastrophic. “The state, in intervening, isn’t providing those supports,” said Lisa Washington, a University of Wisconsin law professor who has written about the intersection of immigration and child protection. “In your most vulnerable moment, when you need medical attention and care, getting that attention or care might start or trigger this cascade of intervention.” The Globe interviewed two mothers from Haiti who shared stories of losing children while receiving inpatient care shortly after arriving in Massachusetts. The parents spoke through interpreters and asked not to be named, fearing their comments could hinder their chances of reuniting with their children. “[Women are] losing their children, and it could be for minor stuff that is not ultimately their fault,” said Carline Desire, executive director of Dorchester’s Association of Haitian Women, which provides support and advocacy to Haitian immigrants. DCF does not track cases by immigration status or nationality, or record how many complaints involve children living in shelters, making it difficult to know how often DCF is involved with immigrant families. Many migrant families’ reliance on social service providers for everything from housing to health care can expose them to scrutiny that leads to DCF’s involvement. Advocates see some families unknowingly run afoul of American parenting standards. People who work with immigrant families, including some raised by Haitian parents, say other cultures may have different standards over how closely children should be supervised, or what kind of corporal punishment is acceptable. The Globe has reviewed police logs in several communities and found police-filed 51A complaints, which trigger a DCF review, included cases where children were left unattended in hotel rooms and instances of domestic violence. DCF’s response — close surveillance, home inspections, or family separation — can be punishment when, in some cases, education would suffice. “We’re not helping those families,” said the DCF worker, who requested anonymity to avoid retribution at work. “We’re actually making things worse for them.” Local advocates’ concerns about migrants and the child protection system are echoed by experts nationally, who say child protection agencies have a track record of overreporting families that don’t fit into a “white middle class frame,” Washington said. Black and Latino children 17 and younger make up about 29 percent of all Massachusetts children but account for almost half of all open DCF cases. The mother who trekked across two continents with her child shared medical records saying she had depression and suicidal ideation, which led to her hospitalization. She was not suicidal, though, she said in an interview. Now, DCF wants her to receive therapy before reuniting with her children, she said, but she can’t find an appointment. The other mother interviewed by the Globe, who received inpatient psychiatric care about three months ago, said she wishes she hadn’t told her therapist she was experiencing depression. “I have only one person here,” she said. “It’s my child.” She was parted from the child on March 4, the mother said, the day she told a doctor about her depression. On her son’s first birthday in mid-March, someone from DCF brought him to a Mattapan church to see her briefly. She brought a birthday cake and took photos to celebrate. “I will never be fine without my son,” she said. “Paradise is not sweet for me.” A still-pending 2021 federal civil rights lawsuit claimed the agency failed to provide sufficient language access for families. A lawyer involved with the suit said little has changed in three years, though DCF did increase spending on interpretation and translation to more than $1 million in the last fiscal year, and in 2022 increased its vendors providing interpretation. Recently arrived families, too, need education in how DCF works and American parenting standards. DCF does outreach to educate recently arrived parents, but several advocates said the effort is insufficient. Other experts worry about a lack of training among mandated reporters, professionals including physicians, teachers, and therapists, legally required to report suspicions of child mistreatment. “People want to offer services but they’re not doing it with cultural sensitivity,” said Carlot Celestin, a psychologist with Mattapan’s Immigrant Family Services Institute, a nonprofit that serves recent immigrants. Aura Obando, a medical director at the Boston Health Care for the Homeless program described one patient who refused therapy for depression because she feared DCF would take her children. - See the full Boston Globe article.
State Pledges to Inspect Hotel Shelters After Roach, Rodent, Mold Complaints While documents provided to MassLive by the Executive Office of Housing and Livable Communities (EOHLC) describe the unsanitary conditions found at some hotels and motels sheltering houseless migrants and permanent Massachusetts residents, they also revealed something else. Though contract language allowed for the Executive Office of Housing and Livable Communities to inspect hotels, it rarely did so. Since September 2022, the state has contracted with 128 hotels at varying points to serve as shelter sites for unhoused families with no place to stay, a requirement resulting from its “right to shelter” law. Records requested by MassLive show state inspectors inspected just about 20 of those hotels. Hotel names and locations were blacked out in the records provided. “These hotels are private businesses that are licensed and inspected by local governments,” a EOHLC spokesperson said in a statement. “Although the state is not the authority that inspects and licenses these hotels, we do reserve the right to visit and examine hotel rooms in response to complaints from families in our shelter system. When we identify issues, we work with the property owner to try to resolve them.” Following multiple complaints from families living in the hotels, most of which have been utilized for less than year so far, the office plans to inspect every hotel used to house a family via an in-house agency inspection team, and to inspect them periodically and annually going forward. When initially placing families in hotels, the state relied on local hotel licensing processes for inspection of hotel conditions. Typically, hotels are inspected yearly by local building departments, while boards of health must ensure sanitary conditions adhere to state law. But state records show those processes proved to be ineffective in some cases. MassLive was unable to identify where because of the redacted nature of the documents. When inspection requests are made, the state receives them through its constituent service team, its service provider partners, and the National Guard and regional response teams that staff and oversee a fraction of the hotel shelter sites. When a health and safety violation was identified in a hotel, state officials usually gave a 24-hour deadline to see it fixed, records show. In one instance, in January 2023, it gave a hotel two months to address the issues, which included mold spores, gnats, mice and bed bugs. But it’s unclear what follow-through took place to make sure violations were taken care of. The EOHLC spokesperson said the state has taken “extensive efforts’ to consolidate down to fewer hotel sites. - See the full Mass Live article.
Healey Signs Bill Banning Revenge Porn Massachusetts has finally banned revenge pornography. Gov. Maura Healey signed the bill into law Thursday, saying it would crack down on a method of coercive control used by domestic abusers. The new law makes Massachusetts the 49th state to enact such a ban, making South Carolina the only outlier without protections against the practice. "This law is about stopping violence and stopping harassment. And it also recognizes The legislation bans the sharing of sexually explicit images and videos without the subject's consent and creates a diversion and education program for adolescents who are involved in sexting. It also installs protections for domestic abuse victims against "coercive control," which can impair people's safety and autonomy. - See the full WBUR story.
Health Care Needs to Diversify its Workforce to Address Racial Inequalities Racial and ethnic inequities in health care are found in every state in the U.S. despite the passage of legislation intended to improve health outcomes for minorities and increased awareness of health care disparities over the past two decades, according to a new national report. The 300-plus-page document from the National Academies of Sciences, Engineering, and Medicine detailed how structural racism and people’s surroundings have contributed to worse health outcomes for minorities. It also offers recommendations and solutions to health care organizations and the federal government, like a more diverse workforce and adjusting payment systems to make health care more affordable. Dr. Georges Benjamin, executive director of the American Public Health Association and co-chair of the committee that wrote the report, said people of color in the U.S. are more likely to experience maternal and infant mortality, lower life expectancy and many chronic diseases. “Inequities are baked into our health care system, and if we address them, everyone benefits,” Benjamin said. Racism and bias from health care providers have also contributed to worse health outcomes, according to the report, which comes 21 years after the first from the organization. The committee behind the report suggested that more practicing physicians who are from diverse backgrounds and from the communities they serve would improve several problem areas; studies show that people of color generally receive better care when treated by those who look like them. The research also showed language barriers persist in health care and that trainings on bias management and ways to become more familiar with cultural issues don’t create long-term improvements in health outcomes for minorities. Health care systems should work to strengthen the ties between patients and providers — so the patient has a voice in their treatment — and bring in important community voices, the report recommended. “Health systems should work with the community to understand what their needs are, and engage them early and often,” Benjamin said. The report’s authors urged Congress, the U.S. Department of Health and Human Services, National Institutes of Health and Centers for Medicare & Medicaid Services to better coordinate their health care equity plans — which the report said are siloed — and to establish a federal oversight body for the implementation of these plans. Other suggested steps involve collecting better health care data at the federal level and providing more money for research and programs proven to reduce racial and ethnic inequities. The quality of health care in the U.S. is not what it should be compared to other high-income countries largely “because we haven’t addressed health inequities,” said Dr. Lisa Cooper, director of the Johns Hopkins Center for Health Equity and one of the report’s reviewers. She said that became even more apparent during the COVID-19 pandemic. Even if it takes years, the recommendations should be implemented, Benjamin said. If not, he said, people will continue to “die unnecessarily, in an unjust way.” - See the full AP story.
‘Concern is Real’ About Long Covid’s Impact on Americans and Disability Claims, Report Says The Covid pandemic has been called a “mass-disabling event” since early on — the kind of once-in-a-generation public health crisis that could shape millions of people’s lives forever. But while more people self-identified as disabled since the pandemic began, applications for disability benefits have stayed level, according to data from the Social Security Administration. That could change as the burden of long Covid becomes clearer. A new report commissioned by the SSA in 2022 captures what we know so far about long Covid, and hints at how the nation’s disability benefits system might need to shift in the wake of the pandemic. As of April, 5.3% of U.S. adults — 13.7 million people — had long Covid, according to survey data from the Centers for Disease Control and Prevention. Studies suggest women are nearly twice as likely as men to experience long Covid. However, long Covid is difficult to map onto the agency’s existing eligibility requirements for disability insurance, says Stephanie Rennane, an economist at the RAND Corporation who’s studied disability benefits. “The severity and duration of the condition can vary a lot, and in ways that we can’t fully predict yet. Even after 4 years, the research landscape in this area is evolving quickly and summary reports like this are a helpful way to translate the state of knowledge into something actionable for policymakers,” she said in an email. A group of experts from across medical disciplines met seven times under the direction of the National Academies of Science, Engineering and Medicine to distill the scientific literature. The outcome is a 200-plus-page document outlining long Covid’s wide reach, both in the population and in individual people’s bodies — taking a toll on various organ systems. “We conclude that long Covid is a real condition,” committee chair Paul Volberding, a professor emeritus of medicine at UCSF, said in a video conference Wednesday. “People suffering from it have to be listened to and have to be believed and deserve the best access possible to the management strategies.” The Social Security Administration has not yet said what it will do with the report’s conclusions. The agency is in the process of updating its long Covid guidance. Here are some of the key takeaways from the report: Long Covid is most likely a long-term chronic illness People with persistent long Covid symptoms “generally improve over time,” the report says, but recovery can plateau six to 12 months after the initial infection. Just 22% of people who have symptoms at six months post-infection make a full recovery by one year. Among those who don’t improve by one year, most remain stable but some worsen. Long Covid’s chameleonic nature poses a challenge to the Social Security Administration, which determines whether people are so disabled by their condition that they can’t work. The agency has a listing of conditions and impairments that are considered severe enough to interrupt someone’s working life. Long Covid isn’t on the list. Neither are conditions like ME/CFS or fibromyalgia. That means “most individuals with long Covid applying for Social Security disability benefits will do so on the basis of health effects not covered in the Listings,” the report’s authors write. And while the administration has issued guidance to its adjudicators on how to field long Covid applications, “it does not provide sufficient guidance for assessing functional status or weighing severity,” the report says. To receive disability benefits, a person has to meet the statutory definition of disability, which for adults means they have a serious and “medically determinable” physical or mental disability that keeps them from participating in the labor force and earning income for at least a year. Children are considered disabled if they have “severe functional limitations” due to a severe physical or mental disability. Proving disability status to gain benefits can be a long and arduous process. If someone’s disability doesn’t match the list of pre-approved impairments, the agency then determines whether it thinks the applicant could hold any job based on their documented level of function (or, for children, whether they could generally participate in their lives). “The ambiguity in diagnosis and variation in symptoms, severity and duration of long COVID and limited knowledge base make it difficult to include long COVID as a listed impairment for SSA at this point,” said Rennane, the economist. “But hopefully this report will give some guidance as to indicators to watch for (such as a prior hospitalization for COVID) which may help determine when the impacts and duration could be severe enough to meet SSA’s eligibility standards for disability insurance.” - See the full Stat News story. |